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CENTRAL INDIANA MEDICAL GROUP
NPI 1639359037
Family Medicine in Indianapolis, IN

Active since November 14, 2007
6349 S EAST ST, INDIANAPOLIS, IN 46227(317) 807-0247(317) 735-1951 Get Directions Write a Review

NPPES record last updated: December 5, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Central Indiana Medical Group NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CENTRAL INDIANA MEDICAL GROUP (NPI 1639359037) is a healthcare organization registered as a family medicine in Indianapolis, Indiana and active in the NPI registry since November 2007. The organization lists Jeffrey N Dewester, Owner, as its authorized official.

NPPES Registry Identity

NPI1639359037
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameGRAND OLE DOCS OF THE SOUTHSIDE, LLC
Location Address6349 S EAST STIndianapolis, IN 46227-7107
Mailing Address1350 E County Line Rd, Suite HIndianapolis, IN 46227-0873 · (317) 887-7725 · Fax (317) 887-7751
Phone(317) 807-0247
Fax(317) 735-1951
Organization SubpartNo
Authorized OfficialJeffrey N DewesterOwner · (317) 807-0247
Enumeration DateNovember 14, 2007
Last NPPES UpdateDecember 5, 2013
✔ NPI 1639359037 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 01036126A
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
6349 S EAST ST, Indianapolis, IN 46227
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Other Names 1

Doing Business AsCentral Indiana Medical Group

Other Identifiers 3

OtherCI4722IN · Group Rr Medicare #
Medicare PIN132440IN
Other5457630005IN · Dme

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AMAZING GRACE MEDICAL CONSULTANTS, LLC
Family Medicine
6349 S EAST ST
INDIANAPOLIS, IN 46227
Marion County (317) 735-1727

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grand Ole Docs Of The Southside, LLC's NPI number?

The NPI number for Grand Ole Docs Of The Southside, LLC is 1639359037. It was assigned to this organization in the NPPES registry on November 14, 2007. The provider is doing business as Central Indiana Medical Group.

Where is Grand Ole Docs Of The Southside, LLC located?

Grand Ole Docs Of The Southside, LLC is located at 6349 S East St, Indianapolis, IN 46227. The listed phone number is (317) 807-0247.

What is Grand Ole Docs Of The Southside, LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Grand Ole Docs Of The Southside, LLC was last updated on December 5, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.